Review Article| Volume 41, ISSUE 2, P299-308, April 2023

Download started.


Equity for Sexual and Gender Diverse Persons in Medicine and Dermatology

  • Julia L. Gao
    Corresponding author. Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03766
    The Fenway Institute, Fenway Health, Boston, MA, USA

    Department of Dermatology, Beth Israel Deaconess Medical Center, 1340 Boylston Street, Boston, MA 02215, USA

    George Washington University School of Medicine & Health Sciences, Washington, DC, USA

    Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03766, USA
    Search for articles by this author
  • Kanika Kamal
    Harvard Medical School, Harvard University, 25 Shattuck Street, Boston, MA 02115, USA
    Search for articles by this author
  • Klint Peebles
    Department of Dermatology, Kaiser-Permanente Mid-Atlantic Permanente Medical Group, 1221 Mercantile Lane, Largo, MD 20774, USA
    Search for articles by this author
Published:February 01, 2023DOI:


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.


      Subscribe to Dermatologic Clinics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Foundation H.R.C.
        We are here: understanding the size of the LGBTQ+ community.
        (Available at:) (Accessed March 30, 2022)
      1. LGBT identification in U.S. ticks up to 7.1%. gallup.
        (Available at:) (Accessed March 30, 2022)
        • Yeung H.
        • Luk K.M.
        • Chen S.C.
        • et al.
        Dermatologic care for lesbian, gay, bisexual, and transgender persons: epidemiology, screening, and disease prevention.
        J Am Acad Dermatol. 2019; 80: 591-602
        • Gao J.L.
        • King D.S.
        • Modest A.M.
        • et al.
        Acne risk in transgender and gender diverse populations: a retrospective comparative cohort study.
        J Am Acad Dermatol. 2022; S0190-9622: 00394-00402
        • Thoreson N.
        • Grasso C.
        • Potter J.
        • et al.
        Incidence and factors associated with androgenetic alopecia among transgender and gender-diverse patients treated with masculinizing hormone therapy.
        JAMA Dermatol. 2021; 157: 348-349
        • Silverberg M.J.
        • Lau B.
        • Justice A.C.
        • et al.
        Risk of anal cancer in HIV-infected and HIV-uninfected individuals in North America.
        Clin Infect Dis. 2012; 54: 1026-1034
        • Kobayashi T.
        • Sigel K.
        • Gaisa M.
        Prevalence of anal dysplasia in HIV-infected transgender women.
        Sex Transm Dis. 2017; 44: 714
        • Ruanpeng D.
        • Chariyalertsak S.
        • Kaewpoowat Q.
        • et al.
        Cytological anal squamous intraepithelial lesions associated with anal high-risk human papillomavirus infections among men who have sex with men in northern Thailand.
        PloS one. 2016; 11: e0156280
        • Campaign H.R.
        Sexual orientation and gender identity definition.
        Human Rights Campaign, 2019
        • Sternhell-Blackwell K.
        • Mansh M.
        • Peebles J.K.
        Residency education on sexual and gender minority health: ensuring culturally competent dermatologists and excellent patient care.
        JAMA Dermatol. 2020; 156: 497-499
        • Zelin N.S.
        • Hastings C.
        • Beaulieu-Jones B.R.
        • et al.
        Sexual and gender minority health in medical curricula in new England: a pilot study of medical student comfort, competence and perception of curricula.
        Med Education Online. 2018; 23: 1461513
        • Obedin-Maliver J.
        • Goldsmith E.S.
        • Stewart L.
        • et al.
        Lesbian, gay, bisexual, and transgender–related content in undergraduate medical education.
        Jama. 2011; 306: 971-977
        • Jia J.L.
        • Nord K.M.
        • Sarin K.Y.
        • et al.
        Sexual and gender minority curricula within US dermatology residency programs.
        JAMA Dermatol. 2020; 156: 593-594
        • Stubbe D.E.
        Practicing cultural competence and cultural humility in the care of diverse patients.
        Focus. 2020; 18: 49-51
        • Khan S.
        Cultural Humility vs. Cultural Competence — and Why Providers Need Both. Bostom Medical Center Health System.
        (Available at:) (Accessed May 1, 2022, 2022)
        • Mansh M.
        • Garcia G.
        • Lunn M.R.
        From patients to providers: changing the culture in medicine toward sexual and gender minorities.
        Acad Med. 2015; 90: 574-580
        • Street R.L.
        • O’Malley K.J.
        • Cooper L.A.
        • et al.
        Understanding concordance in patient-physician relationships: personal and ethnic dimensions of shared identity.
        Ann Fam Med. 2008; 6: 198-205
        • Ayhan C.H.B.
        • Bilgin H.
        • Uluman O.T.
        • et al.
        A systematic review of the discrimination against sexual and gender minority in health care settings.
        Int J Health Serv. 2020; 50: 44-61
        • Mansh M.
        • White W.
        • Gee-Tong L.
        • et al.
        Sexual and gender minority identity disclosure during undergraduate medical education:“in the closet” in medical school.
        Acad Med. 2015; 90: 634-644
        • Mansh M.D.
        • Dommasch E.
        • Peebles J.K.
        • et al.
        Lesbian, gay, bisexual, and transgender identity and disclosure among dermatologists in the US.
        JAMA Dermatol. 2021; 157: 1512-1514
        • Mori W.S.
        • Gao Y.
        • Linos E.
        • et al.
        Sexual orientation diversity and specialty choice among graduating allopathic medical students in the United States.
        JAMA Netw open. 2021; 4: e2126983
        • Streed Jr., C.G.
        • Grasso C.
        • Reisner S.L.
        • et al.
        Sexual orientation and gender identity data collection: clinical and public health importance.
        American Public Health Association, Washington, DC2020: 991-993
        • Schabath M.B.
        • Curci M.B.
        • Kanetsky P.A.
        • et al.
        Ask and tell: the importance of the collection of sexual orientation and gender identity data to improve the quality of cancer care for sexual and gender minorities.
        J Oncol Pract. 2017; 13: 542-546
        • Cahill S.
        • Makadon H.
        Sexual orientation and gender identity data collection in clinical settings and in electronic health records: a key to ending LGBT health disparities.
        LGBT health. 2014; 1: 34-41
        • Boothby-Shoemaker W.
        • Mansh M.
        • Sternhell-Blackwell K.
        • et al.
        Sexual orientation and gender identity inclusion in dermatology research: a ten-year analysis.
        J Am Acad Dermatol. 2022; S0190-9622: 00534-00535
        • Cahill S.
        • Singal R.
        • Grasso C.
        • et al.
        Do ask, do tell: high levels of acceptability by patients of routine collection of sexual orientation and gender identity data in four diverse American community health centers.
        PloS one. 2014; 9: e107104
        • Rullo J.E.
        • Foxen J.L.
        • Griffin J.M.
        • et al.
        Patient acceptance of sexual orientation and gender identity questions on intake forms in outpatient clinics: a pragmatic randomized multisite trial.
        Health Serv Res. 2018; 53: 3790-3808
        • Ruben M.A.
        • Kauth M.R.
        • Meterko M.
        • et al.
        Veterans’ reported comfort in disclosing sexual orientation and gender identity.
        Med Care. 2021; 59: 550-556
        • Price K.N.
        • Alavi A.
        • Hsiao J.L.
        • et al.
        Gender minority patients in dermatology clinical trials.
        Int J Women's Dermatol. 2020; 6: 438
        • Kronk C.A.
        • Everhart A.R.
        • Ashley F.
        • et al.
        Transgender data collection in the electronic health record: current concepts and issues.
        J Am Med Inform Assoc. 2022; 29: 271-284
        • Group G.
        Best practices for asking questions to identify transgender and other gender minority respondents on population-based surveys.
        eScholarship, University of California, Los Angeles, CA2014
        • Crenshaw K.W.
        On intersectionality: essential writings.
        The New Press, New York, NY2017
        • Ruoss A.V.
        • Short W.R.
        • Kovarik C.L.
        The patient’s perspective: reorienting dermatologic care for lesbian, gay, bisexual, transgender, and queer/questioning patients.
        Dermatol Clin. 2020; 38: 191-199
        • Howard S.D.
        • Lee K.L.
        • Nathan A.G.
        • et al.
        Healthcare experiences of transgender people of color.
        J Gen Intern Med. 2019; 34: 2068-2074
      2. Herman JL, Brown TN, Haas AP. Suicide thoughts and attempts among transgender adults: Findings from the 2015 US Transgender Survey. 2019.

      3. National LGBT Health Education Center TFI. Providing Inclusive Services and Care for LGBT People: A Guide for Health Care Staff. 2016. Available at:

        • Krempasky C.
        • Harris M.
        • Abern L.
        • et al.
        Contraception across the transmasculine spectrum.
        Am J Obstet Gynecol. 2020; 222: 134-143
        • Beuttler M.
        • MacGregor J.
        A genderfluid approach to aesthetic language in dermatology.
        J Drugs Dermatol JDD. 2022; 21: 96-99
        • Human Rights Campaign
        ICYMI: As lawmakers escalate attacks on transgender youth across the country, some GOP leaders stand up for transgender youth.
        (Available at:) (Accessed April 37, 2022)
      4. Conron KJ, O'Neill K, Vasquez LA. Prohibiting gender-affirming medical care for youth. 2021. Available at: